In a first, doctors transplant organs between HIV-positive donor, recipients

For the first time in the U.S., doctors performed successful surgeries that transplanted organs from one HIV-positive donor into two HIV-positive patients. Dr. Christine Durand of Johns Hopkins University School of Medicine joins Hari Sreenivasan to discuss.

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    This week, for the first time in the United States, doctors performed successful surgeries that transplanted organs from one HIV positive donor into two HIV positive patients. This has been hailed as a landmark development not only for HIV patients who are at an increased risk of kidney and liver failure, but it is also expected to help reduce the waiting time for all potential organ recipients.

    For more, I'm joined now by Dr. Christine Durand of Johns Hopkins University School of Medicine, who was a part of the medical team that performed the surgeries.

    So, how pig is this problem? Put this in perspective for us. What are the consequences of an HIV-positive person getting transplants?


    So, these transplants are really a historic milestone. Our group has been working for more than six years, and we had a congressional act passed, and this congressional act made it now legal to consider HIV-positive donors for organ transplants. So this is a huge success, not only for our program, for patients with HIV who are waiting for organs but for everyone in the country who is waiting for an organ.

    We have more than 120,000 individuals on the wait list, and we don't have enough organs to go around. So, although this past year we performed more than 30,000 transplants, more than 20 patients die every single day waiting for an organ. So anyway that we can expand the organ supply, helps all of those people in need.


    All right. So, one of the questions people are going to have is how do organs do inside HIV-positive patients? Their immune systems are already suppressed. Is there a risk that the patient and organ won't last as long?


    So, certainly, there was a concern for many years that HIV-positive individuals might not do as well with transplants. But we now have very large studies that have shown that HIV-positive individuals do just as well as those without HIV and it's now standard practice to use HIV-negative donors for HIV-positive patients on the wait list.


    You know, this is maybe a unique question for a group of donors, but the types of drugs that they take and the cocktail that helps keep them alive — I mean, are there risks that come along where the recipient, their body has to kind of accept not just the organ but what's already gone into that organ?


    There are some extra considerations with these HIV-positive-to-positive transplants. We know that the recipients are going to be exposed to the donor's virus. And so, we have to take into account what types of medication are needed to control that virus. We have more than 20 HIV medications, but there are some viruses that have drug resistance.

    So, we have to carefully compare the virus from the donor and the virus from the recipient to make sure that the recipient's HIV medications are still going to be effective.


    Who is most likely to be on this list of HIV-positive patients waiting for transplants? Who does this affect the most?


    So it really affects a large number of individuals with HIV. We've made huge advances and there are far fewer individuals dying from AIDS and infections. But at the same time, as people with HIV live longer, they're developing the same chronic diseases that the rest of the population developed. So, up to a third of HIV-positive individuals will develop chronic kidney disease, and many will also develop liver disease.

    The big deal about this is that once you have these end-stage organ diseases with HIV infection, you're actually at higher risk of dying. So, that means HIV-positive patients on the wait list are even in greater need of these organ transplants.


    All right. Dr. Christine Durand joining us from Johns Hopkins today — thanks so much.


    Thank you.

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